If an unresponsive 57-year-old male is not breathing and the AED announces "No shock advised," what is your next step?

When an AED indicates "No shock advised," it means that the rhythms detected are not shockable, which typically suggests that the patient is either in asystole or a pulseless electrical activity (PEA). In this scenario, immediate action is required to ensure adequate circulation and oxygenation to the vital organs.

Resuming chest compressions is the most critical next step in this situation. High-quality chest compressions help maintain blood flow to the heart and brain, which is essential in a cardiac arrest situation where the patient is unresponsive and not breathing. The focus should be on providing continuous compressions at a rate of 100-120 compressions per minute with adequate depth to ensure effective circulation. Compressions should not be interrupted for any other interventions at this point, as they serve as the primary means of supporting the patient's circulation until advanced care can be provided.

While inserting an oropharyngeal airway and providing ventilations are important components of resuscitation, they should follow the immediate resumption of chest compressions. Checking for a pulse is unnecessary in this context since the patient is unresponsive and not breathing, and it could take valuable time away from critical compressions.